Long Term Care for Activity Professionals, Social Services Professionals, and Recreational Therapists, Sixth Edition
Elizabeth Best-Martini, Mary Anne Weeks, and Priscilla Wirth
Trade Paper, Reproducible Forms, 432 pages
Published by Idyll Arbor
Publication date: 2011
ISBN: 9781882883899

MDS 3.0 has brought many changes to long-term care. Even in facilities that are not required to meet OBRA standards, there are changes underway to meet the goals of person-centered programming. The sixth edition of Long-Term Care covers these changes and provides you with the information you need to provide outstanding care for your residents and participants.

The book is down to earth and easy to understand. It will to answer your difficult questions about working with diverse resident groups, meeting standards, working with team and family members, and managing your department. It lets you see how all the parts of long-term care facilities, assisted living facilities, and adult day programs can fit together to make an empowering, healthful environment for everyone. It shows you how to provide care that satisfies, and even exceeds, health care regulations. It’s a great reference book with many excellent activities and reproducible forms!

The sixth edition includes information on how to pass the new survey procedures and more details on successful person-centered programming. This is the best reference book for activity directors in long-term care facilities. It is the most popular text for training new activity professionals and is recommended as a study guide for the National Association of Activity Professionals Credentialing Center certification exam.


Table of Forms       viii
Index of Activities  ix
Acknowledgments  xi
Purpose   xiii

1. Introduction       1
Culture Change in Long-Term Care        1
The Settings in Which We Work            3
What’s in this Book                7
Terminology           9

2. The People We Serve          11
Theories on Aging   11
Demographics of the People We Serve   14
Myths and Realities of Aging 2000         17
Older Americans Act              19
Imagine Yourself at 84             19
Dealing with Now   21
Reactions to Illness                  22
The People We Serve and Their Families                23
Barbara’s Story       32
Diagnosis and Chronic Disorders            34
MDS List of Active Diagnoses               35
The Diagnostic Intervention Grid            36
Neurological Disorders and Psychiatric Disorders                  46
The Wellness Tree of Life      49
Sensory Loss           53
Saying Goodbye: The Way We Grieve, the Way We Die      54

3. The Work We Do               57
Our History             57
Professional Organizations      60
Professionalism       61
Activity Professional              62
Activity Consultation              68
Social Services Professional     68
Recreational Therapist             74
Teamwork                77

4. Environment      79
Physical Environment              79
Personal Environment             85
Cultural Environment             86
Working Environment             86
Environmental Assessment Form            87

5. Person-Centered Programs 91
Person-Centered Activity Programming                  91
Discovering the Person            93
Cognitive Activity Levels        97
Physical Activity and Exercise with Older Adults                  100
Physical Function and Exercises according to Common Medical Disorders          103
Activity Needs Assessment   105
Activity Review Forms           114
Social Services Review Form  118
OBRA Interpretive Guidelines Tips      121

6. Providing Meaningful Activities      123
Activity Suggestions                123
Challenges and Techniques of Group Work           124
Leisure, Leisure, Leisure         125
Leisure Room          126
Person-Centered Activities     129
Activity Supplies   129
Activity Analysis   132
One-to-One Programming        134
Multi-Sensory, Multi-Level Theme Activities       136
Theme Weeks         136
Intergenerational Programs      142

7. Programming for Individuals with Severe Cognitive Impairments                 145
Programming Overview          145
Sensory Integration                  146
Sensory Stimulation                 150
The Sensory Box    170
Activities for Individuals with Cognitive Impairments           171

8. Programming for Individuals with Mild to Moderate Cognitive Impairments               173
Validating Activities               173
Remotivating/Reminiscing Activities       177
Resocializing Activities           179
Men in a Women’s World      192

9. Short-Term Stay: Rehab-Oriented     196
Cognitive Stimulation and Retraining Activities      196
Short-Term Rehab Activities  213
Community Integration Activities          216

10. Documentation                218
Documentation Principles      219
Introduction to Required Documentation                220
Activity Documentation         223
Social Services Documentation                224
Recreational Therapy Documentation     225

11. Assessments       226
Initial Assessment  226
Activity Assessment              228
Social Services Assessment     231
Recreational Therapy Assessment          235
Standardized Scales and Assessment Tools            235
Discharge from the Nursing Home          239

12. Resident Assessment Instrument and Treatment Planning             242
Purposes of the RAI                242
Overview of the RAI Process                  243
Conducting the Interview       246
Care Planning          259
The MDS for Reimbursement                268

13. Monitoring the Treatment Plan      270
Monitoring Tools — Activities               270
Monitoring Tools — Social Services       274
Quarterly Review   274
The Care Plan         275
Annual Review        279
Other Considerations for Documentation               280
Health Insurance Portability and Accountability Act (HIPAA)             285

14. Councils           286
Resident Council     286
Family Council        294

15. Volunteers         297
Activity Department Volunteers            297
Social Services Volunteers       298
One-on-One Friendship Programs           299

16. Quality Assurance, Infection Control, and Risk Management     300
Quality Assurance  300
Infection Control    307
Risk Management    308
Immediate Jeopardy                310

17. Management    313
Resident’s Rights     313
Restraints                 322
Behavior Management             323
Time Management  333
Budgets    335
Policies and Procedures           336
OBRA Regulations                  338
Surveys   345
Survey Groups        349
Medications in the Elderly     356

18. Summary          359
A. Abbreviations     361
B. Minimum Data Set and the Resident Assessment System                363
C. Care Area Assessments       403
References and Further
Reading           421
Index      425

Elizabeth (Betsy) Best Martini is a Certified Recreational Therapist specializing in the field of gerontology, and long term care. She has a Master of Science Degree in Recreation Therapy / Administration. She also has a State of California RCFE Administrator Certificate as a licensed administrator for assisted living settings.

Betsy has a consulting firm, Recreation Consultation & Best Solutions, that provides recreational therapy consultation to retirement communities, skilled nursing settings, sub-acute settings, state hospitals, cities and counties and residential / assisted care facilities in Northern California.

For more information see her web site: www.BetsyBest.com

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